NEW YORK, June 21, 2010-Despite current policy trends, many
clinicians continue to hold positive attitudes toward gifts from
and marketing interactions with pharmaceutical and device
companies, according to a report in the June issue of Archives of
Surgery, one of the JAMA/Archives journals.

Relationships between clinicians and the pharmaceutical and
medical device industry have received increased scrutiny in recent
years, according to background information in the article. "We now
know that nearly all physicians maintain some relationship with
industry, beginning with near-universal exposure to pharmaceutical
industry marketing during medical school," the authors write. These
relationships range from drug samples and free food in the
workplace to larger payments, such as reimbursement for educational
meetings and conferences and speaking and consulting fees. "With
greater awareness of the prevalence of these relationships has come
greater interest in the potential conflict of interest that they
pose, with recommendations from individuals and organizations to
improve transparency and independent regulation."

The Mount Sinai School of Medicine consortium in the New York
area has a policy that bans or limits marketing-related
interactions between physicians and industry. However, the
effectiveness of such policies remains uncertain, write Deborah
Korenstein, M.D., of Mount Sinai School of Medicine, and
colleagues, who conducted a survey of faculty and trainees in the
11 hospitals in the system in 2008.

A total of 590 clinicians and medical students completed the
survey (response rate, 67 percent), of which 59.5 percent were
male, 39 percent were attending physicians and 23.7 percent of the
non-students were from surgical specialties. Attitudes toward
industry and gifts were generally positive; 72.2 percent of
participants found sponsored lunches appropriate. "Notably, many
participants [74.6 percent] found large gifts unacceptable and,
like participants in previous surveys, believed that other
physicians were more likely to be influenced by gifts and food from
industry than they were," the authors write.

Surgeons and trainees tended to have more positive attitudes
toward industry than others and were more likely to deem some
gifts—including industry funding of residencies and travel
expenses for attending lectures—acceptable. Pediatricians
generally held less favorable attitudes toward industry.
Non-attending physicians held more positive attitudes toward
receiving meals, textbooks and medication samples.

A total of 54.2 percent of the clinicians were familiar with
their institution's policy toward industry interactions, and those
who were unfamiliar held more positive attitudes toward such
interactions. "Our findings suggest the importance of physician
education about the influence of industry, particularly for
trainees and surgical specialists who may be less aware of the
influence of industry and who may in fact be governed through their
specialty bodies by more permissive guidelines. However, large
changes in physician attitudes are likely to require shifts in the
cultural environment of medicine. If physician attitudes become
congruent with the attitudes of the public, the medical profession
may be viewed as part of the solution instead of part of what the
nation at large perceives to be a problem."

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(Arch Surg. 2010;145[6]:570-577. Available pre-embargo to the media
at www.jamamedia.org.)

Editor's Note: Data collected for this work was partially
supported by the Attorney General Prescriber Education Grant
Program administered by the state of Oregon. Senior author Dr. Ross
is supported by a National Institute on Aging grant and by the
American Federation of Aging Research through the Paul B. Beeson
Career Development Award Program. Please see the article for
additional information, including other authors, author
contributions and affiliations, financial disclosures, funding and
support, etc.

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